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A B S T R A C T S
S121
Conclusion:
The oldest-old patients turn their attention
inward; they expect to stay at home with their families and
to suffer no pain. Spousal caregivers on the other hand, find
meaning in taking care of the patient and hold onto hope
for both themselves and the patient. Health care providers
should regard both the patients and their spousal caregivers
as the basic unit of care, each with a different focus of care.
Disclosure of interest:
None declared
Keywords:
Cancer, oldest-old, spouses, caregivers, hope,
distress
P142
THE ROLE OF THE SOCIAL WORKER IN A COMPREHENSIVE
GERIATRIC ASSESSMENT CLINIC FOR OLDER PEOPLE WITH
UPPER GASTROINTESTINAL CANCER
R. Morris
1
, Y. Raza
2,
*, P. McKay
3
, H. Jones
4
1
Health Care for Older People, Nottingham University Hospitals
NHS Trust,
2
Adult Access Service,
3
South Nottinghamshire and
Public Protection, Nottinghamshire County Council,
4
Adult Social
Services, Nottingham City Council, Nottingham, United Kingdom
Introduction:
Older people faced with a cancer diagnosis
endure the multiplicative effects of pre-existing co-
morbidities and the physical, psychological and functional
effects of their malignancy. In upper gastrointestinal (UGI)
cancer these factors are compounded by a generally poor
prognosis and relatively late presentation. These factors
suggest the inclusion of social work in any comprehensive
geriatric assessment (CGA) is likely to be important if such
patients are to successfully negotiate the assault of a cancer
diagnosis on every aspect of their existence and ability to
function.
Objectives:
The aim of this work was to qualitatively
evaluate the scope and potential impact of social work
interventions in the context of an integrated multidisciplinary
CGA team dealing with elders undergoing treatment for UGI
cancer.
Methods:
Consecutive patients (
70yrs) referred to the
UGI Cancer Multi-Disciplinary Team (MDT) were invited for
assessment in a multi-professional Geriatric Assessment
Clinic. All patients were assessed by geriatrician, nurse,
occupational therapist, physiotherapist, dietician and social
worker. Planned interventions were delivered and followed-up
by the CGA team. The role of the social worker was evaluated
through direct observation by independent senior social
services colleagues and by interview of CGA team colleagues.
Results:
The inclusion of social care assessment within a
multi-professional CGA team has been observed to confer a
number of benefits to both patients and the health and social
care system in general:
- Rapid access to assessments earlier in the cancer treatment
pathway
- More concise,accurate and detailed social care assessments
adopting a person centred approach to the assessment
(team-working and case-management)
- Early access to information regarding available resources
and services for patients, carers and families offering
increased choice and control through a direct payments or
a personal budget
- Early relief of financial anxieties through comprehensive
review and access to benefits
- Better targeted support to carers and families that are
outcome focused maximising people’s independence.
- Less duplication of assessments (single point of access
saves time and money)
- Effective communication and integration with multiple
community-based resources
- A more personalised service facilitated by CGA team case-
management
- Enhanced collaborative working with Health resulting in a
more efficient understanding of roles and responsibilities
- More accurate anticipation of needs over the course of
treatment
- More effective and better integrated delivery of ‘end of life’
care planning
- Timely and properly supported transfer of care following
acute hospital treatment
Conclusion:
There are clear benefits to patients, carers and
families deriving from the appropriate integration of social
care workers within CGA teams facilitating the management
of older cancer patients. There are further efficiencies in such
schemes accruing to the wider health and social care system.
Disclosure of interest:
None declared
Keywords:
Comprehensive geriatric assessment, social care,
upper GI cancer
P143
FUNCTIONAL STATUS, QUALITY OF LIFE, AND UNMET
NEEDS IN OLDER PATIENTS WITH LUNG CANCER
K. K.-F. Cheng
1,
*, S. Y. Loh
2
, C. K. Toh
2
, Z. Huang
1
1
National University of Singapore,
2
National Cancer Centre
Singapore, Singapore, Singapore
Introduction:
The majority of lung cancer patients are
diagnosed at advanced stage with poor prognosis. Literature
has indicated that many patients with lung cancer report high
level of unmet needs, and poor level of quality of life (QoL) in
compared with patients with other types of cancer [1,2].
Objectives:
The aim of this study was to examine the
relationship of functional status, QoL and supportive care
needs in lung cancer patients who were 50 years old or above.
Methods:
103 patients diagnosed with either stage 3
(12.6%) or 4 (87.4%) lung cancer completed the Lawton IADL
scale, EORTC-C30 and EORTC-Lung Cancer specific module
(QLQ-LC13), Supportive Care Needs Survey Short-Form
(SCNS-SF34). Eastern Cooperation Oncology Group scale for
performance status (ECOG PS), Charlson Comorbidity Index
(CCI), and Common Terminology Criteria for Adverse Events
(CTCAE) version 3.0 were collected as part of clinical routine
assessment.